Individual provider Active NPI

Elizabeth A Walenz, MD

  • Pediatrics Physician
  • Omaha, NE
National Provider Identifier
1306898903
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
23702 Issued in NE
Practice address
10060 Regency Cir
Omaha, NE 68114-3732
Phone
(400) 235-4132
Fax
(402) 354-1301
NPI assigned
May 16, 2006
Last updated
Jan 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 46311 WI
Pediatrics Physician 208000000X 23702 NE Primary

Addresses

Primary practice location

10060 Regency Cir
Omaha, NE 68114-3732

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 3

IdentifierTypeStateIssuer
10025837400MedicaidNE
1306898903MedicaidIA
47068731742MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110314000173 NE Practitioner - Pediatric Medicine 2365482163 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Pediatrics CurrentSince Feb 28, 2011 Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients

Locations

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

8601 W Dodge Rd
Ste 216
Omaha, NE 68114
Phone (402) 354-4822

Interoperability endpoints

  • Direct secure messaging: elizabeth.walenz@direct.nmhs.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1306898903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10060 REGENCY CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143732",
            "telephone_number": "400-235-4132",
            "fax_number": "402-354-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALENZ",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "46311",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "23702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025837400",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306898903",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731742",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.